American Diabetes Association


These are actual quotes from the American Diabetes Association website:


Myth #2 (from list of Diabetes Myths): People with diabetes can't eat sweets or chocolate.
If eaten as part of a healthy meal plan, or combined with exercise, sweets and desserts can be eaten by people with diabetes. They are no more “off limits” to people with diabetes, than they are to people without diabetes.



Myth #5: If you have diabetes, you should only eat small amounts of starchy foods, such as bread, potatoes and pasta.
Starchy foods are part of a healthy meal plan. What is important is the portion size. Whole grain breads, cereals, pasta, rice and starchy vegetables like potatoes, yams, peas and corn can be included in your meals and snacks. The key is portions. For most people with diabetes, having 3-4 servings of carbohydrate-containing foods is about right. Whole grain starchy foods are also a good source of fiber, which helps keep your gut healthy.





How can I have sweets and still keep my blood glucose on target?
The key to keeping your blood glucose on target is to substitute small portions of sweets for other carb-containing foods in your meals and snacks. Carb-containing foods include bread, tortillas, rice, crackers, cereal, fruit, juice, milk, yogurt, potatoes, corn, and peas. For many people, having about 45 to 60 grams at meals is about right. Serving sizes make a difference. To include sweets in your meal, you can cut back on the other carb foods at the same meal.

For example, you’d like to have cookies with your lunch. Your lunch is a turkey sandwich with two slices of bread. Your first step is to identify the carb foods in your meal. Bread is a carb. You decide to swap two slices of bread for two slices of low-calorie bread and have the cookies -- it’s an even trade. Your total amount of carbohydrate remains the same for the meal.



Can I eat foods with sugar in them?
For almost every person with diabetes, the answer is yes! Eating a piece of cake made with sugar will raise your blood glucose level. So will eating corn on the cob, a tomato sandwich, or lima beans. The truth is that sugar has gotten a bad reputation. People with diabetes can and do eat sugar. In your body, it becomes glucose, but so do the other foods mentioned above. With sugary foods, the rule is moderation. Eat too much, and 1) you'll send your blood glucose level up higher than you expected; 2) you'll fill up but without the nutrients that come with vegetables and grains; and 3) you'll gain weight. So, don't pass up a slice of birthday cake. Instead, eat a little less bread or potato, and replace it with the cake. Taking a brisk walk to burn some calories is also always helpful.


Or take a look at the recipes for breads, muffins, cakes, pies, cookies, and pizza.


My point? As I often say, while the "official" organizations like the American Diabetes Association, the American heart Association, and the USDA dominate the message provided to mainstream Americans, to those of us who know better, they have become irrelevant. You can see how obviously boneheaded their advice is. I'd go so far as to say that, if you want diabetes, follow the American Diabetes Association diet. If you have diabetes, and you'd like to accelerate complications like kidney disease, heart disease, and neuropathy, then follow the American Diabetes Association diet.

I'm going to bet that American Diabetes Association sponsors like Lilly, Novo Nordisk, Merck, Pfizer, Abbott ($1 million or more annual contributions) and Cadbury Schweppes (3-year, multi-million dollar support for Weight Loss Matters program) will continue to charge full-speed ahead to maintain the status quo. Cadbury Schweppes are the proud makers of Dr. Pepper, Hawaiian Punch, Snapple, Motts' Apple Juice, and Hires Root Beer--you know, the foods and drinks that you can have as long as you adjust your insulin dose or talk to your doctor about adjusting your diabetes medications. And if you gain, say, 30 or 40 lbs eating these foods. . . well, we've got a treatment for that. Merck's Januvia , for instance, can help you out for only about $200 a month!

Looking at the facts this way, and it seems like some cheap conspiracy theory: They're all out to get us. Dispense information that virtually guarantees propagation of the disease, and all your friends and cronies profit. I don't know if it is or it isn't, but it sure smells like it sometimes.

Comments (6) -

  • Anonymous

    5/18/2008 11:07:00 AM |

    I used to donate to some of the listed groups.  A week didn't go by without receiving a solicitation to give money for a "good cause".  Often I would give a little.  A few times a neighbor lady personally sent to me an AHA donation form.  She knew my grandfather, and knew he battled heart disease for many years.  

    After reading your blog, and am now a follow of the TYP program, I no longer donate to the groups.  I've learned they are part of the problem.  Last time the neighbor sent forms I went to see her personally on why I will no longer being donating.  She tried to convince me other wise.  Hopefully  she reads your blog now, and has a better understanding on why I feel the way I do.

  • Nyn

    5/18/2008 2:24:00 PM |

    I am shocked at this. I guess I shouldn't be, but wow. I grew up with a Type I diabetic mother, and throughout my childhood, I remember her struggling with her blood sugar and diet. She minimized sugar as much as possible, and while yes she could eat starches, she felt best, had best results, and kept her weight moderated only when she severely lowered them. This information goes against everything I ever heard her deal with, as well as all the other diabetic info I've come across. Are they trying to get on the 'it's not so bad to have a chronic condition' bandwagon, or truly sell more wheat? The more I read your blog and other literature about the food/medical 'establishment', the more fed-up I'm getting. Is this kind of nonsense going on in other countries? Are their health and drug associations misleading them too?

  • Stan

    5/18/2008 3:15:00 PM |

    Quote:  "The key to keeping your blood glucose on target is to substitute small portions of sweets for other carb-containing foods..."

    This is in my humble opinion akin to telling an alcoholic to drink smaller shots of vodka more often!

    Every time you take or even look at a small portion of food, our brain causes some insulin release preceeding a digestion therefore for people who are prediabetic or diabetic (type 2) eating more frequenltly may initially boost the insulin release (somewhat) through this effect which may improve blood glucose control, but eventually it will only exacerbate the whole problem.  The problem is the insulin resistance and the resulting hyperinsulinemia which will continue getting worse over time on the AHA and ADA diets!

      Boosting one's insulin release through frequent eating will help maintaining a better blood glucose control but will lead to higher serum insulin and therefore higher risk of developing diabetes, obesity, cardiovascular disease and cancer.  

    ADA should change their name to American Diabetes Promotion Assoc.

    Stan (Heretic)

  • Anna

    5/18/2008 7:01:00 PM |

    When I was diagnosed with gestational diabetes a decade ago, I was initially given the ADA's exchange system to follow, which resulted in higher BG readings than on my own regular diet.  One reason, I discovered, was that one slice of my usual "whole grain" flour bread was very dense, and weighed more (more carbs, too) than the airy, white flour bread the ADA assumes everyone eats.  So I switched to weighing food and carb counting for better BG results.  Eventually it was just easier for me  to manage my BG just by dropping the sugar and starches altogether (a two oz portion of pasta is about 14 penne - by the time I ate two penne pcs to test for doneness, the remaining portion looked so frustratingly small I figured why bother?).

    Now officially being diagnosed pre-diabetic (though my labs are fairly normal if I stick to LC), I get a lot of cr*p in the mail about how to manage diabetes from my insurance co and the ADA (always with a donation solicitation).  Most of it goes right into the recycling bin.

    It was in the newspaper, though, that I read an ADA spokesperson's comment that stuck in my head, that it wasn't "fair" to make people with diabetes avoid sugars and their favorite starchy foods - that those "treats" should be available as they are to everyone else!  Fair???  What's "fair" got to do with it?  To quote my mother, "nobody ever said life was fair!" - one of the most valuable notions she ever drilled into my head.   What's *fair* about cr*ppy dietary advice that allows/causes diabetic complications too numerous to mention, quality of life deterioration, and painful misery that can last decades, especially when they can be avoided or dramatically slowed/reduced simply by restricting sugars and starches to a minimum?  *Fair*, that would be funny, if wasn't so deadly serious.

  • Sarah

    5/24/2008 3:28:00 AM |

    I'm diabetic with a current A1c of 5.2%. A good number that I achieved and maintain by doing everything the American Diabetic Association says not to do. I do not eat sugar. I keep my daily carb intake around 40-50 grams. I get 95% of those carbs from non-starchy vegetables and a limited amount of fruit (berries). I don't eat grains, period. And I test my blood glucose often and carefully and totally ignore the insane "tight control" parameters promoted by the ADA.

    The ADA is not the friend of the diabetic. Jenny Ruhl had a terrific idea: diabetics should organize and "threaten" legal action against the ADA for its treatment guidelines that are killing and maiming thousands upon thousands of diabetics.

    Keep up the great blog. I enjoy reading it and have taken away good information, as well as ammunition.

  • jpatti

    6/4/2008 4:52:00 PM |

    I've told this story many times before, but...

    I was diagnosed with T2 diabetes while a PhD candidate in biochemistry 20 years ago.  The doctor gave me the ADA pamphlet about what to eat.  One day, I ran across a veterinary pamphlet about treating animals with diabetes and it was diametrically opposed to the ADA pamphlet, which made me curious enough to go into the research library to find out WHY humans were different from every other animal.

    I read research about how various foods affected normal people, T1s and T2 diabetics and saw the bg profiles for meals consisting of carb, protein and fat and various combinations.  I saw the veterinarians were right and briefly considered seeing a vet for my bg control, but decided I'd just manage it on my own.  

    I had no idea why the ADA was so far off base, but... a few months later, I saw a newspaper article covering an ADA press release.  The ADA had admitted that starch was equivalent to sugar, which as a biochemist, I already knew and was a bit surprised they'd just figured that out!  Starch is just a polymer of glucose, any biochemistry textbook shows you that.  

    But... the article went on to say that since this was so, the ADA was changing it's recommendations to allow diabetics to eat sugar.

    WTF?!??!

    At that point, I decided the ADA was hopelessly stupid and I've never paid any attention to them since.  

    I see from this blog post that they're still  saying this today.  Bunch of morons.

    NO ONE has to follow the ADA today.  

    You don't have to have access to a research library to learn about diabetes on your own, we've got PubMed and such sources online today.  

    And if you don't "speak" research, you can read Jenny's site which does a wonderful job of translating for laymen what the current research actually shows:  http://www.bloodsugar101.com/

    But there's even a better tool today than research in using our own glucometers to see *exactly* how specific foods effect each of us rather than relying on research.  Everyone, no matter how educated or uneducated, can find this out for themselves by testing with a Walmart or Walgreens generic meter bought for under $10.  

    IMO, that doesn't just apply to diabetics, but also those with metabolic syndrome and other forms of prediabetes or reactive hypoglycemia.  You can take control of your bg right *now* at home without the need for a doctor or any ability to follow the research.  

    The most important info for controlling your bg is NOT from the ADA, but this post about testing for yourself: http://www.alt-support-diabetes.org/NewlyDiagnosed.htm

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Does fish oil cause blood thinning?

Does fish oil cause blood thinning?

Omega-3 fatty acids from fish oil have the capacity to "thin the blood." In reality, omega-3s exert a mild platelet-blocking effect (platelet activation and "clumping" are part of clot formation), while also inhibiting arachidonic acid formation and thromboxane.

But can fish oil cause excessive bleeding?

This question comes up frequently in the office, particularly when my colleagues see the doses of fish oil we use for cardiovascular protection. "Why so much fish oil? That's too much blood thinning!"

The most recent addition to the conversation comes from a Philadelphia experience reported in the American Journal of Cardiology:

Comparison of bleeding complications with omega-3 fatty acids + aspirin + clopidogrel--versus--aspirin + clopidogrel in patients with cardiovascular disease.(Watson et al; Am J Cardiol 2009 Oct 15;104(8):1052-4).

All 364 subjects in the study took aspirin and Plavix (a platelet-inhibiting drug), mostly for coronary disease. Mean dose aspirin = 161 mg/day; mean dose Plavix = 75 mg/day. 182 of the subjects were also taking fish oil, mean dose 3000 mg with unspecified omega-3 content.

During nearly 3 years of observation, there was no excess of bleeding events in the group taking fish oil. (In fact, the group not taking fish oil had more bleeding events, though the difference fell short of achieving statistical significance.) Thus, 3000 mg per day of fish oil appeared to exert no observable increase in risk for bleeding. This is consistent with several other studies, including that including Coumadin (warfarin), with no increased bleeding risk when fish oil is added.

Rather than causing blood thinning, I prefer to think that omega-3 fatty acids from fish oil restore protection from abnormal clotting. Taking omega-3 fatty acids from fish oil simply restores a normal level of omega-3 fatty acids in the blood sufficient to strike a healthy balance between blood "thinning" and healthy blood clotting.

Comments (20) -

  • Marc

    10/26/2009 9:46:32 PM |

    Long time reader, first comment.
    Thank you for so freely sharing all the information.

    Marc

  • Daniel

    10/26/2009 11:02:46 PM |

    Thank you for this!  I have had this question for a long time given the number of things I take that "thin the blood."

  • Kevin

    10/26/2009 11:44:45 PM |

    As a veterinarian I've dispensed fish oil capsules for several years.  Some owners give so many that the dogs smell 'fishy' when seen for routine care.  The owner doesn't smell it since they're with the dog a lot.  The coats are gorgeous, something that doesn't often happen in Wyoming at 7000ft altitude.

  • Dr. William Davis

    10/26/2009 11:47:45 PM |

    Hi, Kevin--

    My two Boston terriers jump for their fish oil capsules, two every day!

    I'm glad to hear from a veterinarian that the coat sheen is indeed from the fish oil.

  • Rich

    10/27/2009 1:27:09 AM |

    Due to an afib episode a couple of years ago, I was taking 20 mg of warfarin per day, plus around 5000 mg of EPA+DHA, and never had bleeding issues.  

    My INR was always a stable 2.0.

    As I've not had an afib reoccurrence, I've replaced the 20mg coumadin with 325mg aspirin daily, and still take around 5000 mg EPA+DHA.  No bleeding issues with that combo either.

  • Catherine

    10/27/2009 3:55:32 AM |

    Glad this topic came up.
    Over the last 5 years, I've had to periodically eliminate my fish oil intake as I would start to bruise badly. My internist said she has seen this occasionally with fish oil and called it "capillary fragility." I bruise easily anyway, but it would really get bad with fish oil. So there must be some quality in fish oil that influences this.

    Then about 6 months ago I started a strong supplement change to help with my low bone density--already taking magnesium and calcium but added:
    Boron, K2, silica,pomegrantate juice, and BIG increase in vitamin D.
    I also increased omegas to 3,000 a day which I was not able to tolerate before.

    It has been over 4 months since I have had ANY bruise---which is just unheard of for me. I usually have 3-4 different bruises on arms/legs. So something in these supplements  strengthened my capillaries I guess, and I can now take high fish oil doses!
    Anyone else had a bruising problem with fish oil?

  • Dr. William Davis

    10/27/2009 11:04:59 AM |

    Hi, Catherine--

    Fascinating observation!

    I'll bet it has something to do with the vitamin D, more than anything else. Vitamin D seems to strengthen structural tissues in bones, muscle, heart valves, and perhaps capillaries and other small blood vessels.

  • trix

    10/27/2009 11:59:37 AM |

    Several years ago I bruised easily for a while and attributed it to taking garlic supplements daily.  I started taking Vit C and the bruising stopped.  I don't think it had to do with fish oil (in my case); I don't think I was taking fish oil at the time.

  • Daniel

    10/27/2009 9:37:33 PM |

    I too achieve rapid blood thinning when taking 2400mg of EPA/DHA per day. That's only 4 pharmaceutical grade capsules. Even after my vitamin d levels were normalized I still got bruising.

    I now take Vitamin K2 (MK-7 natto extract) twice a week and it's allowed me to bump my EPA/DHA up to 3600mg with no ill effects or bruising.

    It was either supplement or eat a lot of aged cheese, they both seemed to do the trick in my particular case.

  • Healthy Oil Guy

    10/27/2009 9:53:51 PM |

    Thank you for sharing this study with us.  It helps clarify whether there is a risk for blood thinning from taking fish oils.  This information may help individuals who are taking blood thinning medications and considering adding fish oils to their daily diet.

  • Dave

    10/28/2009 2:22:01 AM |

    Catherine,

    Without a doubt, your cessation of bruising was due to vitamin k2. I routinely take nattokinase, large doses of fish oil, curcumin, and other blood thinning agents, and if I don't take vitamin K2, I will begin bruising. (I also take high doses of Vitamin D). When I take K2, I have absolutely no bruising.

    Vitamin K2 has many clinical trials showing that it helps endothelium  integrity and elasticity.

    Also, grapeseed extract and pine bark extract (specifically oligomeric proanthcyanins) has the same beneficial effect.

  • Catherine

    10/28/2009 4:41:41 PM |

    Daniel,

    That's really interesting! There is a lot of research on K2's effect on strengthening weak bones. Bone fractures go down considerably when high doses of K2 are used (Japan is using K2 as osteoporosis treatment) BUT studies show it needs to be in conjunction with adequate calcium and Vitamin D---they work synergistically for bone strength.  So it makes sense that K2 and D could do the same with strengthening fragile capillaries. I am also taking the M7 natto form.

  • Catherine

    10/29/2009 12:01:36 AM |

    Dave,

    Thanks for sharing your experience with this, you've really confirmed it now for me.  I can't believe I have suffered with this for most of my life with no answers (tried high dose Vit C, grape seed, etc) and now within months on K2, there's no bruising and I can tolerate fish oil. Hope my bones are responding this well!
    This blog is so helpful....

  • Mina

    10/29/2009 12:21:31 PM |

    Thanks for posting this. The question recently came up in our office. I like your assertion that omega-3s restore the blood to normal and remove abnormal clotting. And to comment on a post above, our dog has a beautifully shiny coat and takes 2 pure EPA capsules each day!

  • Term papers

    1/26/2010 3:40:08 PM |

    I have enjoyed reading That During nearly 3 years of observation, there was no excess of bleeding events in the group taking fish oil. (In fact, the group not taking fish oil had more bleeding events, though the difference fell short of achieving statistical significance.

  • Viagra Online

    8/23/2010 6:41:39 PM |

    I've been drinking fish oil for many year and I don't have any chance in my body people use to said me that but I think it is just a rumor.

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    11/3/2010 10:19:55 PM |

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  • moseley2010

    12/7/2010 2:37:16 AM |

    I haven't heard of this problem
    fish oil supplements. But now we know what to tell them when this sort of concern comes up. Fish oil or Omega-3 is really beneficial to health. It's just important that it comes from clean waters.

  • Jack

    3/12/2013 7:03:38 PM |

    What is an appropriate dose of fish oil for someone taking coumadin?

  • dorange

    6/15/2014 3:53:03 PM |

    Dr. Davis, when  person is taking Tamoxifen...
    (1) is it safe to take vitamin k2 or K1?
    (2) will fish oil have a role in preventing blood clots?

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